The guidelines provide screening, risk assessment, and treatment recommendations for various lipid disorders

The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) announced the publication of updated clinical practice guidelines for dyslipidemia management and atherosclerosis prevention, introducing a new cardiovascular risk category and accompanying lipid management goals.

The clinical practice guidelines serve as a guidance on screening, risk assessment, and treatment recommendations for various lipid disorders. The 2017 update includes a new cardiovascular disease "Extreme Risk" category and lipid-lowering treatment goals. The Extreme Risk category includes:

patients who have a progressive cardiovascular disease, including patients with unstable angina, after achieving an LDL cholesterol level <70mg/dL

patients who have established cardiovascular disease accompanied by diabetes mellitus, chronic kidney disease (stages 3 or 4), or familial hypercholesterolemia

men aged ≤55 years or women aged ≤65 years who have a history of premature cardiovascular disease

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The guidelines highlight the importance of assessing women for cardiovascular disease using tools to determine the 10-year risk for a coronary event. The risk (high, intermediate, or low) should be assessed using the Reynolds Risk Score or the Framingham Risk Assessment Tool (Grade C).

Also, dyslipidemia in childhood and adolescence should be diagnosed and managed as early as possible to decrease the long-term risk of cardiovascular events in adulthood (Grade A). LDL cholesterol <100mg/dL is categorized as Acceptable; 100–129mg/dL is Borderline; and ≥130mg/dL is considered High.

The guidelines also include an assessment of the value of adding ezetimibe and PCSK9 inhibitors in patients with cardiovascular disease who are unable to reach LDL cholesterol goals with statin therapy. When ezetimibe is coadministered with statins, an additional 25% reduction in LDL is observed resulting in a total 34–61% reduction in LDL. Ezetimibe can be used in combination with statins to further reduce both LDL-C and ASCVD risk (Grade A). PCSK9 inhibitors should be considered in patients with clinical cardiovascular disease who are unable to reach LDL-C/non-HDL-C goals with maximally tolerated statin therapy (Grade A).